Anxiolytics | ||||
| NAME | EQUIVALENT PO DOSE, mg | ONSET OF ACTION | HALF-LIFE, h | COMMENTS |
|---|---|---|---|---|
| Benzodiazepines | ||||
| Diazepam (Valium) | 5 | Fast | 20-70 | Active metabolites; quite sedating |
| Flurazepam (Dalmane) | 15 | Fast | 30-100 | Flurazepam is a prodrug; metabolites are active; quite sedating |
| Triazolam (Halcion) | 0.25 | Intermediate | 1.5-5 | No active metabolites; can induce confusion and delirium, especially in elderly |
| Lorazepam (Ativan) | 1 | Intermediate | 10-20 | No active metabolites; direct hepatic glucuronide conjugation; quite sedating; FDA approved for anxiety with depression |
| Alprazolam (Xanax) | 0.5 | Intermediate | 12-15 | Active metabolites; not too sedating; FDA approved for panic disorder and anxiety with depression; tolerance and dependence develop easily; difficult to withdraw |
| Chlordiazepoxide (Librium) | 10 | Intermediate | 5-30 | Active metabolites; moderately sedating |
| Oxazepam (Serax) | 15 | Slow | 5-15 | No active metabolites; direct glucuronide conjugation; not too sedating |
| Temazepam (Restoril) | 15 | Slow | 9-12 | No active metabolites; moderately sedating |
| Clonazepam (Klonopin) | 0.5 | Slow | 18-50 | No active metabolites; moderately sedating; FDA approved for panic disorder |
| Clorazepate (Tranxene) | 15 | Fast | 40-200 | Low sedation; unreliable absorption |
| Nonbenzodiazepines | ||||
| Buspirone (BuSpar) | 7.5 | 2 weeks | 2-3 | Active metabolites; tid dosing-usual daily dose 10-20 mg tid; nonsedating; no additive effects with alcohol; useful for controlling agitation in demented or brain-injured pts |